Though tough when we’re in the thick of it, we might also consider this season of life to be a window of opportunity—a chance to shake things up—to focus on ourselves instead of everyone else, take back control of our health, reevaluate our working definition of success and balance, and revamp our habits overall.
Just as each woman’s perimenopause symptoms differ considerably, so do individualized treatment plans to address them. Fortunately, we have options:
PHARMACOTHERAPY
Menopause Hormone Therapy (MHT) for perimenopause has been given a bad wrap for over two decades due to widespread misinformation.
It can, however, be a life-changer (it was for me). Hormone therapy is not medication, but simply a restoration of hormones previously present that have now precipitously declined (leading to those troublesome symptoms).
Depending on your health history and needs, your provider might prescribe a low-dose birth control pill or a combination of estrogen and progesterone.
Though I am a huge proponent of SSRIs (anti-depressants such as Lexapro and Prozac) when warranted for anxiety or depression, perimenopausal women are unnecessarily being prescribed them when, in actuality, MHT is what’s needed. Once a woman’s hormones are addressed, her symptoms of anxiety or depression often resolve, as well.
So, how do we know if anxiety, depression or perimenopause (or a combo) is the cause of our symptoms? It’s not always simple and easy to determine—life is complex and ever-changing.
To clarify, ask yourself:
Am I in my late thirties to early fifties? Have my periods changed in length, time between, and flow? Am I experiencing other possible perimenopause symptoms?
Do I have a history of anxiety or depression and/or have I experienced mood disturbances during previous windows of vulnerability (puberty/periods and pregnancy/postpartum)?
If yes, you may benefit from the combination of MHT, SSRIs, and Psychotherapy.
If no, but you are now struggling with anxiety-related symptoms, feeling emotionally numb, irritable or ragey, the combination MHT and therapy might be best.
Have I experienced recent pronounced stressors that might be contributing to feelings of anxiety or depression? (Remember, just because it is a common life transition or even a positive change, doesn’t make it stress-free).
If yes to this and no to perimenopause symptoms, it might be best to treat the mood disorder first with SSRIs and psychotherapy.
PSYCHOTHERAPY
I am of the mind that everyone can benefit from therapy, provided it is in service of self-awareness, growth, support, and accountability.
What breaks my heart, though, is seeing someone spinning her wheels in therapy when what would resolve (or greatly abate) her distressing symptoms is MHT.
Cognitive Behavioral Therapy (CBT), mindfulness or Mindfulness-Based Cognitive Therapy (MBCT), and behavioral therapy can all be beneficial—whether used solely or as part of your treatment plan (especially if you are not a candidate for MHT or SSRIs).
Seeking guidance from a menopause-informed provider can help clarify and collaboratively create a course of action.
LIFESTYLE HABITS
You know this one. (Doesn’t mean we do what we know is good for us, though!)
These habits are even more crucial during a window of vulnerability/opportunity—and it’s never too late to begin:
Movement/exercise
Nutrition/alcohol/caffeine
Sleep/rest
Play/fun/nature
Mindfulness/mindset
Purpose/connection
Obviously, this is not an exhaustive list and doesn’t serve as medical advice. I do hope it empowers you to take the right next step toward feeling better and taking charge.
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